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1316049000
CLINTON L BOOMGARDEN
ATLANTA, GA
NPI
1316049000
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: GA 2221)
Enumeration Date
2006-09-02
Last Update Date
2007-07-08
Business Address
Prof. CLINTON L BOOMGARDEN PA
59 EXECUTIVE PARK SOUTH NE SUITE 2098
ATLANTA, GA 30329-2208
Phone number: 404-778-7230
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Mailing Address
Prof. CLINTON L BOOMGARDEN PA
59 EXECUTIVE PARK SOUTH NE SUITE 2098
ATLANTA, GA 30329-2208
Phone number: 404-778-7230
Copy
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